The effectiveness of a health care system is routinely judged by the care patients receive. Far less attention is given to the conditions under which that care is delivered. Health care policy continues to emphasize insurance coverage, access to care, rising costs, workforce shortages, and health outcomes. Yet one question remains largely unaddressed: Who is caring for our physicians?
Physician well-being has traditionally been viewed as an individual concern. Current evidence suggests physician distress is often shaped by the policies and conditions under which medicine is practiced, making physician well-being an appropriate and necessary focus of health care policy.
The practice of medicine requires physicians to make life-altering decisions while navigating increasing administrative demands, staffing shortages, regulatory requirements, and emotionally taxing clinical situations, all while consistently delivering safe, ethical, high-quality care. Little attention has been given to whether physicians have the time, support, and resources necessary to care for themselves. Research suggests that many physicians delay or forgo their own health care because of limited time, concerns about confidentiality, and lack of employer support. More recent research suggests that these challenges extend beyond individual workload or personal resilience. Administrative burden, electronic health record requirements, workflow demands, and organizational culture have become recognized contributors to physician distress.
Burnout is one of the most widely recognized manifestations of physician distress. A 2022 review in the Journal of International Medical Research defines burnout as “a state of emotional exhaustion, physical fatigue and cognitive weariness caused by long-term uncontrolled and unresolved work stressors” and, in some cases, persistent personal or environmental adversity. Although physician burnout has declined from pandemic-era levels, nearly one in three physicians still report symptoms of burnout, a rate substantially higher than that observed in other professions.
Although burnout remains an important part of the discussion, growing attention has been given to moral injury. A 2024 commentary in Mayo Clinic Proceedings explains, “Moral injury is marked by a transgression of one’s values.” A 2024 article in Federal Practitioner similarly describes moral injury as the frustration, anger, and helplessness that arises when business interests and health system obligations prevent physicians from placing their patients’ needs ahead of organizational priorities.
That same commentary reported that 76.2 percent of resident physicians in one study screened positive for moral injury, which was significantly associated with emotional exhaustion, depersonalization, low self-compassion, and imposter syndrome. Other concerns included depression, posttraumatic stress disorder, and suicidal ideation. These effects can reach beyond the physician, influencing the quality and availability of patient care. Burnout can also lead physicians to reduce clinical hours or leave practice, further affecting an already strained health care workforce.
For decades, health policy has focused on expanding coverage, improving access, and reforming payment systems. Medicare, Medicaid, the Children’s Health Insurance Program, and the Affordable Care Act each address significant gaps in health care. These reforms have transformed who receives care and how it is financed, yet comparatively little attention has been given to the physicians responsible for delivering that care. A 2021 Mayo Clinic Proceedings article describes a shift from individual responsibility toward recognizing the influence of health care systems, organizational leadership, and practice environments. A 2025 analysis in the Canadian Medical Education Journal similarly argues that meaningful progress depends upon addressing structural conditions rather than relying primarily on wellness initiatives or individual resilience.
Some may argue that physician well-being should remain the responsibility of individual physicians and the health care organizations in which they practice. Health care organizations play an important role in creating supportive practice environments, developing physician leaders, and supporting physician well-being. However, many of the conditions contributing to physician distress, including administrative requirements, reimbursement policies, regulatory expectations, and barriers to ethical clinical decision-making, extend beyond the control of any individual physician or health care organization. Addressing physician well-being requires shared responsibility among physicians, health care organizations, professional societies, and policymakers.
Health care reform has transformed access to care and reshaped health care delivery. The next step is ensuring that the physicians responsible for delivering that care are supported by the systems in which they practice. Physician well-being belongs within health care policy because it directly influences patient care, workforce stability, health care costs, and the long-term sustainability of our health care system. Caring for our physicians is not separate from caring for patients; it is fundamental to the future of health care.
Perhaps the next major advance in health care should begin with a different question: What responsibility should health policy have in sustaining the physicians upon whom health care depends?
Heather Buckley is a doctoral student.
